Emergency Department Performance Improvement – Victoria, Australia
Through a multi-year partnership between the Victorian Department of Health, Australia and the Institute for Healthcare Improvement (IHI), the Timely Emergency Care (TEC) program has supported hospitals across the state to improve patient flow. The program enabled a coordinated, system-wide approach to reducing delays, improving decision-making, and increasing effective use of capacity.
Impact at a Glance: Timely Emergency Care Program
9.6 hours earlier
Average discharge time for admitted patients
2,600+ admissions avoided
Unnecessary admissions among older patients
75,000+ bed days freed
Through improvements in patient flow
69% seen on time
Urgent emergency department patients, up from 61% over two years
IHI's role:
- Partnered with the Victorian Department of Health to design and guide the TEC Program
- Established the program structure using evidence and leading practice
- Supported health service teams through improvement methods, coaching, and shared learning
- Helped teams identify, test, and scale changes suited to their local settings and system-wide goals
Public Hospital Report Card 2026
Australian Medical Association
Australian Medical Association
Following two consecutive years of improvement, Victoria now leads the nation in the percentage of urgent emergency department patients seen on time.
Clinical Faculty, Timely Emergency Care
Department of Health Victoria
Department of Health Victoria
We’re not just seeing data move – we’re seeing mindsets shift. Teams are more confident, more aligned, and more focused on what matters for patient flow.
Director, Timely Emergency Care
Department of Health Victoria
Department of Health Victoria
The calibre of advice and support provided [by IHI] has significantly enhanced the quality and impact of our initiatives.
The Challenge
Like many health systems, Victoria faced increasing demand for emergency care, rising access delays, and growing pressure on inpatient capacity. Performance was constrained by availability of beds and variability in how patients moved through the system. Efforts to improve flow were often localised, making it difficult to achieve sustained, system-level impact.
The Approach
Across the TEC Program, a series of collaboratives and improvement initiatives focused on different opportunities to improve patient flow and reduce delays across the patient journey. This included reducing length of stay in emergency departments, avoiding unnecessary hospital admissions, reducing length of stay for patients admitted to hospital, and increasing the use of alternative pathways of care, including care at home. The TEC Program brought together 28 hospitals across Victoria to work on shared priorities, learn from each other, and apply improvement methods in a coordinated way.
Key changes implemented across the system included:
Earlier senior clinical decision-making to reduce delays and avoid unnecessary admissions
A stronger focus on discharge earlier in the day to improve bed availability
Better use of Emergency Department short-stay units and fast-track pathways to manage patient flow
Reducing unnecessary waiting between steps in the patient journey
Creating alternative pathways for older patients to receive appropriate care outside hospital
The collaborative model enabled teams to test and adapt these changes locally, while contributing to a shared, system-wide effort supported by data, peer learning, and improvement science.
Results
Across Australia, most hospital performance indicators declined in 2025/26. Victoria was the only jurisdiction to improve in more than two of the four key measures monitored by the Australian Medical Association.
The impact of The TEC Program extended far beyond process improvement. By freeing more than 75,000 inpatient bed days and avoiding thousands of admissions, the initiative effectively created substantial new capacity within the existing system. These gains were achieved not through expansion, but through redesigning care delivery and improving patient flow, resulting in better access, more efficient use of resources, and improved patient care.
Charts/Data
Learnings
System-wide improvement requires alignment across organisations, not isolated local effort
Focusing on how patients move through the system can unlock significant capacity without adding resources
Combining clinical leadership, data, and structured improvement methods supports more consistent and sustainable change
A collaborative approach accelerates learning and enables faster spread of effective practices
What’s Next Section
In 2026, the work evolved into TEC 2026, bringing together several streams of improvement work into a more integrated program focused on improving patient flow across the entire patient journey.
The program initially focuses on timely access to the right pathways of care, reducing delays across the hospital journey and avoiding unnecessary admissions, with an increasing focus on improving progression and flow through inpatient care. As part of this broader work, TEC 2026 also continues to improve care for older people, including through the development and spread of front door frailty models.
Funder:
Department of Health, Victoria
Partners:
Department of Health, Victoria
28 Health Services from across the state of Victoria
Ambulance Victoria